Despite many encouraging advances in the prevention, diagnosis and treatment of heart disease, heart attacks remain the largest cause of death in the US. Many of those heart attacks happen suddenly and cause a life-threatening abnormal heart rhythm called ventricular fibrillation. Patients frequently suddenly collapse, and without prompt restoration of a normal heart rhythm, survival is unlikely.
There are two critical factors that determine whether the patient will survive without serious brain injury. The first is the time from collapse to restoration of normal heart rhythm, which usually happens through the use of an electrical defibrillator. The second factor is whether the patient receives CPR during that time.
This is a very difficult subject to study since obviously patients canâ€™t be randomized to different groups. (Who would sign up for placebo CPR?) The recommendations also have to be simple enough to be taught to the general public and then remembered and executed during a very stressful time. Despite these limitations, the recommended CPR procedure has undergone many revisions since I first learned CPR.
This week, the American Heart Association took another step in making CPR something that anyone can do. They removed the mouth-to-mouth breathing from the algorithm and just left the chest compressions. The reason is that in sudden collapse due to a heart attack the lungs are already inflated with air, and the blood is already oxygenated. So artificial respiration isnâ€™t needed, just artificial circulation. These new recommendations also remove the potential for transmission of infection from mouth-to-mouth contact.
The new recommendations are incredibly simple. If you see someone collapse:
- Call 911
- Push hard and fast in the center of the chest
FOXNews article about the new CPR recommendations
New CPR recommendations on the American Heart Association website
Statistical trends from the Centers for Disease Control on the 5 leading causes of death in the US
This week, the popular media all decided to debunk the myth that drinking 8 glasses of water a day has any health benefits, as you can read in these articles from Reuters, Chicago Tribune and Slate. My regular readers learned that last year.